High-flow priapism following perineal trauma in a child.

Priapism is a rare condition in children and can be classified as high or low flow. We present a case of traumatic high-flow priapism that was successfully managed by selective embolisation of a branch of the internal pudendal artery. The pertinent clinical features are antecedent trauma and prolonged painless partial erection. The investigation of choice is Doppler ultrasound. Management can either be conservative, radiological or surgical. While conservative management can be safely attempted for 6 weeks, given the nature of the condition, early intervention is often required. Radiological embolisation is the first line and is successful in 97% of cases. Surgery carries a higher morbidity and is only reserved in cases where repeated embolisation has failed. This case highlights the importance of a thorough history and careful interpretation of imaging with protocolised follow-up of patients by a paediatric urologist for early and accurate diagnosis of erectile dysfunction and prompt intervention to prevent future complications.